### IN THE COURT OF APP EALS OF TENNESS EE AT JAC KSON Ma rc h 20 , 200 7 S es sio n
PATRICE ALL EN, ET AL 

### . v. M ET HO D IS T H EA LT HC A R E M EM P HI S HOS PITAL S, ET AL 

### .
Direc t Appeal from the Circ uit Court for Sh elby County No. CT-006444-02 D ’Ar m y Bailey, Jud ge

No. W2006-01558-C OA-R3-C V - F iled April 2, 2007

This is a medical malprac tice action in w hich the jury found in favor of Def endant hospital. Plaintiff
asser ts Defe ndant’s expert wa s not qua lified under T ennesse e Code Annotated § 29-26-115( a)( 1), and that the m atter acc ording ly should be remanded for a new trial. We reve rse the tr ial court’s or der denying Plaintiff’ s motion for new t rial, vacate the judgme nt on jury verdic t, and remand for a new trial. Tenn. R. App . P . 3 Appeal as of Right; Judgme nt of th e Circ uit Court Aff irm ed in p art; Reve rsed in part; Vac ated in part and Rem anded

D AVI D R. F ARMER , J. , d e li v e r e d th e o p in io no f

th e c o u r t, in w h ic h W. F RAN K C RAW FORD , P.J ., W.S ., and H OL L Y M. K I RBY , J ., joined.

Carroll C

. J o hnson, I I I , and Timothy R. Holton, Memphis, Tennessee, f or the a ppellant, Patrice Allen.

J ohn E. Hall, J r. and Robert L . Shannon, J r., Atlanta, G eorg ia, for the appellee , Methodist Healthca re Me mph is H os pit a ls.

OP IN ION

Th is i s a me dic a l malp ra c tic e /w ro ng fu l death ac tio n f ile d b y the mot he r o f a c hil d b or n w ith
sever e bra in damag e. On November 12, 2001, Plaintiff Patr ice Allen (Ms. Allen) then pre g nant, was admitted to a hospital operated by Def endant Me thodist Healthcar e Memphis Hospitals (“the Hospital”) in Memphis at appr ox imately 12:00 noon. Pit ocin, a labor -inducing drug, was administered to Ms. Allen and monitors were attache d to trac k the fetal hear t rate a nd Ms. Allen’s
c on tr a c tio ns . Pitoc in wa s disc on tin ue d at ap pr oximate ly 6:4 5 PM, an d Ms. A lle n r e c e ive d c e rv idi l,
a ce rvica l ripening ag ent. At approximately 12:33 AM on November 13, the fe tal monitor indicated a fe tal bradycar dia, or a decline in the fe tal hear t rate. Ms. Allen e x perie nced a place ntal abruption (s e pa ratio n o f p la c e nta

fr om ute ru s) and he r c hil d, Ke nto n, wa s d e liv e re d b y c e sa ri an s e c tio n s ho rt ly-2-

afte r 1:00 A.M. Kento n wa s b orn with sever e bra in damag e and subse quently died in Dec ember 2003.

On Novembe r 12, 2002, Ms

. Allen fil ed thi s lawsuit ag ainst the Hospital and the phy sicians and nurse s who attende d her dur ing la bor and de livery . I n h er co mplaint, Ms. Allen alleg ed the neg lige nce of

the phy sicians and the H ospi tal’s nursing staff c aused K enton to suffe r a pe riod of hy pox ia prior to deliver

y , which re sulted in brain d am age

. She asser ted that the medications
a dmi nis te re d to he r b e tw e e n a dmi ssi on to t he ho sp ita l and de liv e ry

c a us e d h e r ute ru s to be c ome hy pe r- sti mul a te d, re su lti ngin c on tr a c tio ns that w e re to o f re qu e nt a nd too pr olo ng e d. She a lso
asser ted that monitoring established that Kenton experienc ed in utero ta chy car dia and br ady car dia, and that a c esar ian sec tion should have bee n perf o rm ed ea rl i er

. She contends that ha d a ce sarian section bee n perf

ormed sooner , the injury

to Kenton would have been aver ted. Ms. Allen alleg ed De fe nd ant p hy sic ians and nurs e s n e g lig e ntl y

fa ile d to re c og nize the g ra vit y of he r c on dit ion

a nd to
a c t pr omp tly

to p re ve nt hy

pe rs timulatio n o f t

he ute ru s, wh ic h c a

us e d th e pla c e nta l a

br up tio n. Ms. Allen pray ed for compensatory damag es for herse lf and Ke nton in the amount of $30,000,000. She additionally

pray ed for

punitive damag es i n the amount of $30,000,000. Following Ke nton’s death, Ms. Allen filed a sug g estion of death and amende d her c omplaint to assert damag es ar ising fr om wr on g fu l de a th. Ms. Al le n a lso vo lun tari ly no n- su ite d h e r c la ims a g a ins t the ind ivi du a l D e fe nd a nts

. Ms. Allen’s ac tion ag ainst the Hospital was tried befor e a jury from January 30 to Febr

uary 23, 2006. At trial, Ms. A llen offe red the expert testimony of Carl Reddix , M.D., and the Hospital of fe re d th e e xpe rt

te sti mony

of John Ed

wa rd Va nH oo y do nk , M. D. (D r. Va nH oo y do nk ), to e sta

bli sh the s tandar d of professional car e applicable in Memphis. The jury returne d a verdict in favor of the Hospital and t he trial court entered judgment on the j ury verdic t. Ms. Allen moved the cour t for a new tria l asserting , int e r a lia , th at t h e t ri al court e rre d in admitting the testimony of Dr. VanHooydonk over her objection beca use Dr. VanHooydonk was not qualified a s an expert under the locality

rule. The trial court denied Ms. Allen’s motion for a ne w trial on June 19, 2006. The trial court a lso denied the Hospital’s motion for discretionary costs. The matter was timely

appea led to t his Cou rt . We re ve rs e the tr ia l c ou rt ’s den ial of M s. Al le n’ s mo tio n f or ne w tri a l, v a c a te ju d g me n t o nthe ju

r y v e r d ic t i nf

a v o r o f th e H o s p it a l, an d

r e ma n d th is matt e r

f o r a n e w tr ia l. We
a ff ir m th e tr ia l c ourt ’s or de r d e nyingthe Ho sp ita l’ s mo tio n f or dis c re tio na

ry c os ts.

Issue Presented

Ms. Allen raises se vera l is s u es for our revie w per

taining to the tr ial court’s a dmission of
ev id e n c e , li mi tati o n o f te s ti mo n y , li mi tati o n o f c r o s s
- e xa mi n a ti o n , an d li mi tati o n o f o pening and closing statements. The dispositive issue, howeve r, i s wh ether the Hospital’s expert, Dr. VanHooy donk, was prope rly

quali fi edt o t es t i fy

un d er T en n es s ee C o d e A n n o t at ed§ 2 9 -2 6 -1 1 5 (a)(1).

Anal y sis This appea l require s us once a g ain to c onsider the require ments and constraints of Te nnessee Cod e Anno ta te d § 29 -2 6- 11 5( a ). Th e statut or y se c tio n p ro vid e s:-3-

(a) I n a malpra ctice a ction, the claimant shall have the burden of proving by evidenc e as provided by

subsection (b): (1) The rec og nized standa rd of acc eptable profe ssional pr actic e i n the profes s i o n an d the spec ialty there of, if any , that the def endant pr actice s in the community

in which the cla imant prac tices or in a simil ar community at the time the alleg ed injury

or wrong ful ac tion occurr ed; (2) That the defe ndant acte d with le ss tha n or fa iled to act with ordinar y and
rea sonable c are in acc ordanc e with such standa rd; and (3) As a proxi mate re sult of the defe ndant’s neg lige nt act or omi s s i on, the plaintiff suffe red injuries w hich would not otherwise ha ve occ urre d. Tenn. Code Ann. § 29- 26-115(a )(2000)

. Under subsection (a )(1) , known as the “l o ca l i t y rule,” a par

ty proff eringexpert testimony regarding the applica

ble standar d of ca

re must demonstrate that the expert has knowledg e of the sta nd ard of c are a pp lic a ble in t he de fendan t’ s commun ity or in a c omm un ity that th e pa

rt y demonstrates is similar to that of the de fenda nt . E.g., Robinson v. LeCorps , 83 S.W .3d 718, 724 (Tenn. 2002). This Court repe atedly has held that mere ly asser ting familiarity with the local standa rd of care is not sufficie nt to demonstrate knowledg e under the s tatutory standard. E.g., Eck

ler v. Allen , No. W2005-02501-COA-R3-CV, 2006 WL3422105, at *4 (Te nn. Ct. App. Nov. 29, 2006)( perm. app. pending)( ci t i n g J

oh ns on v . P ra tt , No. W2003-02110-COA-R3-CV, 2005 WL1364636, at *7 (Tenn. Ct. App. J une 9, 2005)( perm. app. de nied

)( ci t i n g Mabon v. Jac kson-M adison County Gen. Ho sp . 9 68 S.w .2 d 8 26 , 8 31 (T e nn . Ct . App . 1 99 7) )) . Rathe r, the ex pert mu st pr e se nt f a c ts de mon str a tin g ho w h e or sh e ha s obta ine d kno wl e dg e of the sta nd ard of c are in e ith e r t

he c omm un ity in which the def

endant pr actice s or in a similar community

. Id. The burden of demonstrating that the expert witness is qualified under the sect i o n i s on the party proff eringthe witness, and is the
same whether the witness is offer ed by the plaintiff or de fenda

nt . Carpenter v. Klepper , 205 S.W .3d 474, 483 (Tenn. Ct. App. 2006).

I n this case, Ms. Allen a sserts the Hospital fa iled to car ry its burden to demonstrate that Dr. VanHooydonk is qualified to offe r expert testimony under § 29- 26-115(a )(1) , particu l ar l y in light of thi s Co ur

t’ s r e c e nt ho ld in g inEck ler v. Allen , N o

. W2 0 0 5

- 0 2 5 0 1

- CO A

- R3

- CV , 2 0 0 6 WL 34 22 10 5 ( Te nn . Ct . App . N ov. 29, 2 00 6) . In h e r d e mand fo r r e lie f, sh e a sk s th is C ourt to r e ve rs e the tr ia l c ourt ’s jud g me nt a nd to r e mand

thi s matte r f

or a ne w tri a l.

I t is undisput ed that Dr . VanHooydonk prac tices in Nashville and not in M em p h i s . Dr. VanHooydonk completed his medica l residenc y at Vande rbilt H ospital in Nashville, is a member of the fa culty

at Vande rbilt, and all the hos pitals at which he holds privileg es ar e located in Nashville. Howeve r, the Hospital off ere d no evidenc e that Na shville is a community simil ar to Memphis.

We acc ording ly

turn to whether

Dr. VanHooy donk demonstrated knowledg e of the standard of ca re a pplicable to nurses in Memphis hospit al pra ctice f or the purpose s of § 29-26-115( a)( 1). The Hospital asserts Dr . VanHooydonk demonstrated fam i l i ar ity with the applicable standard of car e-4-

wher e he te stified that he has inter acte d with Memphis phy sicians and nurses at a number of medica l le c tur e s and

wh e re he ta

ug ht a c on tin

uin g me dic a l edu c a tio n in Mem ph is on time ly

int e rv e nti on

in obstetrics. The H ospital asserts that Dr. V an H ooy donk’s teac hing e x perie nce r eg ardingintervention in obstetrics make s him particularly qualified to testify

in this m atter. A lthough the H ospital arguably has shown that Dr. VanHooydonk’s cre dentials demonstrate knowledg e of an optimum or
national st and ard

of c are , w e a g re e wi th M s. Al le n th a t th e Ho sp ita l ha s f a ile d to de mon str a te knowledg e of the standard of car e in Me mphis, or in a simil ar community , for the pur poses of the statute.
This Court r ece ntly addre ssed a similar cir cumstance in Eck ler v. Allen . I n Eck

ler , the expert medical witness of

fer ed by plaintiff demonstrated expert knowledg e of his spe cialized field of Mohs microg raphic surg ery . The witness a sserted that he had be come f amiliar with the standard of ca re applicable to surg eons per forming Mohs micr og raphic surg ery in Memphis through discussingthe applicable standard with Memphis phy sicians and by survey ing the Memphis surg eons who pe rfor m th i s specialized proc edure

. Id . I n Eck ler , w e no te d th a t e vid e nc e of kn ow le dg e of

a natio na l,
re g io n a l, o r e v e n s tate

- w id e s ta n d ar d o f c ar e is n o t s u f

f ic ie n t to d e mo n s tr a te f

a mi li ar it y w it h the applicable standard of

car e under

the locality

rule. Id. at *5 (c itations omi tted). We note d that the knowledg e re quired by

the statute is persona l knowledg e, or knowledg e gaine d “in per son without the i nterve ntion of another.” Id. (citing W e bs te r’ s Ni nth Ne w Co lle

gia te Di c tio na ry , 877 (1986))

. I t is, in shor

t, f irst-hand knowle dg e. Id. (citing Sta te v . H owa rd , 9 26 S.W. 2d

57 9, 58 5 ( Te nn . Cr im. App. 1996)). I n Eck

ler , w e a g re e d w ithde fe nd ant/ a pp e lle e ph y sic ian th a t di sc us sin g the a pp lic a ble sta n d ar d o f c ar e w it

h p h y s ic ia

n s w h o p r a c ti c e in th e lo c a li ty d o e s n o t s a ti s f y th e r e quirement of knowledg e for

the purposes of

§ 29-26-115( a)( 1). Id. at *6.

We likewise hold he re that Dr. VanHooydonk’s discussions with Memphis phy sicians and
nurs e s at me dic a l le c tur e s do e s no t c on sti tut e pe rs on a l kn ow le dg e of the sta nd ard of c are a pp lic a ble in Memphis under the sec tion. W e also hold that, al t h oug h Dr. Va nHooy donk’s teac hing of continuing e ducation cla sses in obstetric i nterve ntion impl ies knowledg e of a national standar d of
car e, it does not demonstrate knowledg e of the standard of car e in the Memphis community . The Hospital does not asser

t that the applicable standard of car e is otherwise demonstrated by qualified
e xpe rt te sti mony

in e ith e r t he 15 40 pa g e te c hn ic a l r e c or d, 44 vo lum e tr ans c ri pt, or nume r ou s e xhibi ts in this case.

Hol din g
I n light of the fore g oi n g an d p u rs u ant to the constra ints of the locality rule c odified at Tenne ssee Code A nnotated § 29-26-115( a)( 1), we reve rse the trial cour t’s order denying Ms. Allen’ s motion for new tria l. I f, as this Court has sugg ested, the loc ality rule ha s become outdated in light of advanc ed contempora

ry medical training and prac tice, it is within the purvi ew o f t h e Genera l Assembly to amend it. The trial c ourt’s entry of judg ment in favor of the Hospital is vacated, and thi s ma tte r is re mand e d fo r a ne w tr ia l. B e c a us e our d e te rm inatio n o f t his iss ue is d isp os iti ve of

thi s appea l, additional issues raised by Ms. Allen are preterm i t t ed

. We affir m the trial court’ s order-5-

denying the Hospital’s motion for discre tionary costs. Costs of this appea l are taxed to the Appellee, Me tho dis t H e a lth c are Me mph is H os pit a ls.

___________________________________ DAVI D R. FARMER, J UDGE